Introduction

Nutrition is essential at all life stages for overall health, however childhood is a time of increased need for proper nutrition. Key nutrients are needed to promote healthy physical and cognitive growth and development. Unfortunately, the vast majority of American children are not consuming healthy diets. While federal programs and policies aim to provide children with healthy options during the school day, more needs to be done in terms of continuous education and exposure to healthy habits in schools.

State of childhood nutrition

Children currently have the worst nutritional status out of any age group. The United States Department of Agriculture (USDA) created a Healthy Eating Index as a measure of diet quality. This score measures how closely Americans are following the Dietary Guidelines set forth by the USDA. These guidelines are updated every 5 years to reflect up-to-date research on the nutrition recommendations for Americans.  A perfect score of 100 would indicate that all guidelines are being met. Adolescents aged 14-18 have the worst Healthy Eating Score out of any age group at 51 out of100. The 9-13 age group is close behind with a score of 52 and ages 5-8 have a score of 55.

Recent studies show the majority of children’s diets come from ultra-processed foods that are often high in calories and low in essential nutrients. Calories from added sugar and fats, often in the form of these processed foods, make up 40 percent of children’s caloric intake. Furthermore, while sugar-sweetened beverage consumption has started declining, 6 in 10 children still consume a sugar-sweetened beverage on any given day. Overconsumption of foods high in sugar and fat is only part of the problem. Adolescents are eating incredibly low amounts of fruits and vegetables as well. Only 9 percent of high schoolers are meeting the fruit recommendation and that number drops to 2 percent when looking at vegetable intake. This is a key area to address when looking at improving childhood nutritional status.

Health consequences of poor nutrition

Poor childhood nutrition is problematic because research shows that poor health outcomes early in life are predictive of poor health outcomes later in life. For example, currently, the prevalence of obesity in children ages 2-19 is 19.3 percent, almost 4 times what it was in the 1970s. Children who were overweight between 24 and 54 months were over 5 times more likely to be overweight at age 12. Those were obese by age 19 had an 88.3 percent probability of being obese at age 35. Childhood obesity can also take a toll on children’s mental health which is also an ever-increasing problem. Obesity can lead to other chronic health conditions such as type 2 diabetes, heart disease, high blood pressure, and more which are costly both to our healthcare system and economy as a whole.

 A recent study has shown that if obesity rates declined, that could lead to $60 billion less spent on treatment and $254 billion in increased productivity. On the other hand, escalating disease in future generations could lead to a reduction of $5.7 trillion in real GDP. It is vital to address this issue at the childhood level to increase the likelihood of healthier future generations.

When looking at future health outcomes, chronic conditions such as obesity and diabetes have a direct effect on health but there are indirect influences as a result of poor nutrition as well. Education is a major driver of health outcomes. Children who are consuming poor diets are at risk for lower academic achievement. Studies have found diets high in saturated fat can impair cognitive development, and up to 88 percent of children exceed the recommended level for these fats. Nutrition can also affect mood and behaviors such as self-regulation, attention, and aggression. Conversely, research has also shown that improving nutrition and physical activity can boost academic performance.

Federal Programs and Policies

Most children split their time between home and school and therefore it is important to look at what kids are eating both in and out of school. About 60 percent of kids in the U.S. participate in the National School Lunch Program and the School Breakfast Program. Major reforms to these programs were made in 2010 in an effort to combat the rise in childhood obesity. These reforms were successful in that they substantially increased the average Healthy Eating Score of the meals in both programs. That being said, there are still gaps in place that lead to less healthy options being consumed at school.

As stated above, fruit and even more so vegetable intake is a key area of concern for children. A recent report showed plate waste was highest for vegetables with 31 percent of vegetables being wasted. This indicated that just because children are being offered healthy options at school, doesn’t mean they are actually consuming them. Furthermore, just because reforms have been made to school lunch guidelines does not mean they are always followed. In elementary schools, 40 percent of school lunches are still exceeding caloric limits. Only 56 percent of daily lunches met all the nutrition standards. Students need to be empowered to make their own healthy choices both in and out of school.

Moving Forward

While there are certainly external factors that have been shown to influence obesity rates such as socioeconomic status, race, access to healthy foods, and the state in which you reside, it is important to take individual behaviors into account as well. It is estimated that 40-50 hours of education are necessary to change behavior. Most students get less than 8 hours of nutrition education every year and the percent of schools who require nutrition education is on the decline. With the rise of childhood obesity and other diet-related conditions, this is alarming. Establishing healthy eating habits in childhood is essential to long-term health outcomes. Studies have shown that increasing exposure to different fruits and vegetables and being involved in the growing process can improve predictors of intake. By implementing education surrounding healthy eating, agriculture, and how to shop for and prepare healthy meals, children can establish habits and skillsets that will last into adulthood. By tackling these issues early on, chronic disease can be prevented both in childhood and later in life resulting in fewer healthcare costs and a more productive economy.